This invention is based on a Disclosure Document filed in the U.S. Patent And Trademark office on Jun. 6, 2001 and entitled INTELLIGENT SELECTION SYSTEM FOR ELECTROSURGICAL INSTRUMENT.
The invention is directed to an electrosurgical instrument, and in particular to an intelligent selection system and a handpiece for use in such a system for controlling an electrosurgical instrument or apparatus.
Electrosurgical instruments are well known and widely used in the medical, dental, and veterinarian fields. They offer the capability of precision cutting and coagulation with electrosurgical currents preferably in the megacycle range using a handpiece with, for example, needle, ball, or loop electrodes in a unipolar operating mode or with a forceps in a bipolar operating mode. Ellman International, Inc. makes available an electrosurgical instrument for Radiosurgery which provides on its front panel connectors for receiving the plug of a cable-connected unipolar handpiece and a ground or indifferent plate, as well as connectors for receiving the plug of a cable-connected bipolar electrode. One form of such an instrument is described in U.S. Pat. No. 5,954,686, whose contents are incorporated herein by reference. Such instruments are characterized by different modes and sub-modes of operation. For example, the instrument described in the patent, which is typical of other similar instruments, has a cutting mode, separable into CUT and CUT/COAG sub-modes, and a coagulation mode, separable into HEMO, FULGURATE, and BIPOLAR sub-modes.
In a typical surgical setting using such an instrument, a surgeon may first use a handpiece while the instrument is in its cutting mode to perform a desired cutting procedure and then desire to use the same handpiece for coagulation of blood vessels while the instrument is in its coagulation mode. To this end, the electrosurgical instrument has on its front panel push buttons or switches for activating internal circuitry for switching the electrosurgical instrument from its cutting to its coagulation mode or vice-versa. A current electrosurgical instrument contains a power-supply-controlled radio-frequency (RF) oscillator which generates RF currents typically in the megacycle range as high-frequency AC waves. For most cutting purposes, the AC waveform is fully filtered to produce an approximate DC waveform. For most coagulation purposes, the AC waveform is partially rectified (commonly half-wave rectification) to produce the characteristic half-wave rectified waveform. This is accomplished by switching in certain rectifier and filter components for the cutting mode, and switching in certain rectifier components for the coagulation mode. This is well known in the art and further description is unnecessary. Suffice to say, the switching action occurs inside the instrument when the front panel controls are activated by the surgeon.
To simplify mode selection by the surgeon, it is known to place on the handpiece two finger-activated switches that can be connected by appropriate wiring to the electrosurgical instrument and wired in parallel with the front panel switches so that activation of either the finger switches on the handpiece or the front panel switches will allow mode selection. This is similar to the connection and operation of a foot switch that can be used by the surgeon to activate and deactivate the RF currents. More modern electrosurgical instruments, however, do not lend themselves to such a simple approach. The typical modern electrosurgical instrument is computer-controlled, typically by a microcontroller (xcexcC); hence simple parallel-connected circuitry may not work satisfactorily. Another problem is that the standard handpiece has only three terminals, one of which is dedicated to carrying the high-frequency or RF electrosurgical currents; hence, mode selection must be carried out in a safe manner using only two of the three terminals.
A further complication in the use of such instruments is the variety of surgical procedures to which the instrument can be applied, often with different electrodes. Each surgical procedure typically requires not only a particular electrosurgical mode, such as cut or cut/coag, or hemo, but also may require a different set of mode conditions, such as the power setting and/or a different time duration of power application.
With four therapeutic waveforms available in current Radiosurgery instruments and a wide power range, it is time consuming and memory dependent on the part of the surgeon and or staff to tune in the correct waveform and power settings for the particular procedure to be carried out. Also there may have been occasions when electrosurgical injuries may have occurred due to incorrect waveform settings and incorrect power settings for the chosen procedure.
The principal object of the invention is an intelligent selection system for an electrosurgical instrument for use by the surgeon that depends primarily on the surgical procedure to be employed.
Another object of the invention is an intelligent selection system for use by the surgeon that depends primarily on the surgical procedure to be employed and can be controlled by the handpiece chosen by the surgeon to perform the procedure.
A further object of the invention is a handpiece-controlled electrosurgical instrument in which the choice of the handpiece controls the operating mode of the instrument and, preferably, also the mode conditions, such as the power setting that is desired for carrying out that particular procedure.
These objects are achieved in accordance with one aspect of the invention by a novel what may be termed intelligent electrosurgical system that incorporates multiple sets of stored or preset operating modes and conditions that allows the surgeon to select a particular set customized for the particular procedure to be carried out. So, for example, if procedure A is to be carried out, then set A is automatically selected, set A prescribing the electrosurgical mode of operation and one or more of the mode conditions specific to the selected procedure. Similarly, if procedure B is to be carried out, then set B is automatically selected, set B prescribing the electrosurgical mode of operation and one or more of the mode conditions specific to the selected procedure.
In principle, the selection system can be implemented by operating a multiple-position switch or switches on the front panel of the instrument, each switch or switch position being associated with one of the stored sets of operating modes and conditions. However, in accordance with a preferred feature of the invention, the selection is incorporated into the handpiece chosen by the surgeon. While it is possible to build into the handpiece a fingerswitch for each of the stored sets of modes, this has the disadvantage that if the surgeon presses the wrong fingerswitch, then the wrong operating mode for the current procedure may be inadvertently selected. It is therefore preferred in accordance with another feature of the invention to provide a family of intelligent or smart handpieces, each dedicated to a particular procedure.
In this preferred embodiment of the invention, each dedicated handpiece has incorporated in it means for generating a unique control signal that when processed by a computer in the electrosurgical instrument will automatically select that particular set of mode conditions specific to the procedure to which the handpiece is dedicated. There a number of different ways in which this feature can be implemented and the description that follows will describe several of the ways.
It is also possible to go to the next step and control the appearance of the handpiece, for example, by color-coding or by its shape, so that the surgeon understands that a specific colored or shaped handpiece is associated with a specific procedure, which will further minimize the possibility of surgeon error.
As a further feature of the invention, instead of providing handpieces which can typically receive one of several interchangeable electrodes, the electrode appropriate for the specific procedure can be molded into or otherwise fixed to the intelligent handpiece and made a permanent integral part of the handpiece, further minimizing the possibility of the surgeon choosing the wrong electrode for the specific procedure.
In a preferred embodiment, a handpiece construction is similar to the standard two-fingerswitch, three-terminal handpiece used heretofore except that means are included in the handpiece such that, when a first fingerswitch is activated, a first current level signal is outputted and when a second fingerswitch is activated, a second current level signal is outputted, both preferably from the same terminals. The means are chosen such that a xcexcC in the instrument can distinguish the two current levels and activate the appropriate operating mode, for example, a cut mode for that particular procedure or a hemo mode for that particular procedure.
In another preferred embodiment, a handpiece construction incorporates memory means, preferably, a non-volatile memory clip, that stores information representing a set of mode conditions which when transmitted to the electrosurgical instrument automatically selects for the instrument that particular set of instrument mode conditions specific to the procedure to which the handpiece is dedicated.
The various features of novelty which characterize the invention are pointed out with particularity in the claims annexed to and forming a part of this disclosure. For a better understanding of the invention, its operating advantages and specific objects attained by its use, reference should be had to the accompanying drawings and descriptive matter in which there are illustrated and described the preferred embodiments of the invention, like reference numerals or letters signifying the same or similar components.